Life from a Wellcome Trust perspective

Let’s talk about sex

Asking people about their sex lives is an important part of understanding health and wellbeing. The Wellcome Trust’s Media Relations Manager, Craig Brierley, explains more about the Natsal study, which published its latest findings today.

Natsal infographic

In the late 1980s, at the height of the HIV epidemic, a group of researchers from University College London and the London School of Hygiene and Tropical Medicine set about scientifically studying the UK’s sexual behaviour and attitudes. Following a successful pilot study, they asked the Economic and Social Research Council (ESRC) for funding to carry out the complete study.

The idea that researchers – taxpayer-funded researchers – would pry into the nation’s bedrooms was beyond the pale for the Conservative government at the time. “Thatcher halts sex survey” read the headline in the Sunday Times on 10 September 1989. In what must rank as one of its fastest ever funding decisions, the Wellcome Trust stepped in, recognising the urgency of the research, and agreed to pay for the study.

We’ve come a long way since then. The survey – the National Survey of Sexual Attitudes and Lifestyles (Natsal) – is now in its third wave. It is conducted every ten years, still with funding from the Wellcome Trust, but now also from the Medical Research Council, the ESRC and the Department of Health. It is a large study – this time round, over 15,000 people were interviewed, a representative cross-section of the British public. For the first time, the researchers extended the age range beyond 16-44 years, interviewing people up to 74 years old.

So what did Natsal find? As a nation, we start having sex at a relatively early age. The median age at first sex among 16-24 year olds is 16, though only a minority (around 30%) have sex before they are 16. Our sexual activity continues into later life, too – 42% of women and 60% of men aged 65-74 report having had at least one opposite sex sexual partner in the year before they were interviewed, although the frequency of sex reduces with age. Yet despite this – and the perceived sexualisation of our society – we appear to be having sex less frequently, from over six times a month ten years ago to just under five times a month for both sexes among those aged 16-44.

Using the data

For the first time, Natsal has measured the prevalence figure for the number of people who have been made to have sex against their will: one in ten women and one in 70 men. This is not a trivial number – it means you are likely to know someone who has had sex without their consent. And of these people, less than half have ever reported it to anyone. This is clearly a serious problem, with implications for the support services that are available – and, equally importantly, for how we prevent it happening in the first place.

Natsal infographic

There are some positive findings from the survey, particularly relating to sexually transmitted infections. There is evidence that the vaccination programme to combat the strains of human papillomavirus that can cause cervical cancer is beginning to reduce levels of infection within the target age groups, and that people are making use of the National Chlamydia Screening Programme. The last wave of Natsal surveys helped inform both programmes.

Natsal infographic

The researchers looked, too, at the relationship between ill health and sex. Close to one in six people in Britain say that their health affects their sex life, rising to three-fifths among people who say they are in bad health. Yet despite this, only a quarter of men and under a fifth of women who say that ill-health affected their sex life in the past year sought help from a health professional. If they did, it was usually from their GP. This suggests that health professionals may need to consider giving greater attention to providing appropriate advice on patients’ sex lives as part of their wider health.

Data from Natsal is important for informing strategies for tackling sexually transmitted infections, unplanned pregnancies, teenage sex and much more. As befits a study of this magnitude, there is an extraordinary amount of data to unpick and analyse. Today, TheLancet has published six research papers and one framing paper from the research team. This is only the start: over the next decade we can expect to see many more.

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